http://hdl.handle.net/20.500.14342/13 2026-04-21T14:10:38Z http://hdl.handle.net/20.500.14342/6152 Standardized language systems for the design of high-fidelity simulation scenarios: A Delphi study Raurell-Torredà, Marta; Llauradó-Serra, M.; Lamoglia Puig, Montserrat; Rifà Ros, Rosa; Díaz Agea, José Luis; García-Mayor, S.; Romero-Collado, Angel Purpose This study aimed to identify which of the standardised Nursing Interventions Classification (NIC) activities should be used in the design of clinical cases with high fidelity simulation for educational preparation of undergraduate nursing students in non-technical skills. Design and methods A three-round Delphi study was carried out: the first round with taxonomy experts, the second round with academic and clinical lecturers with limited experience in the simulation-based learning methodology, and the third round with academic and clinical lecturers having at least two years of simulation experience. The NIC interventions were grouped into two levels of competence in accordance with the undergraduate nursing degree curriculum (1st- and 2nd-year students, the “novice” level; 3rd- and 4th-year students, the “advanced” level). The NIC allows the description of nurse student competencies in multiple clinical scenarios and throughout various contexts: theory, clinical practice and simulation. Findings The experts identified 163 interventions in 8 areas as relevant and feasible, selecting 42 for the “novice” students, in Nursing Fundamentals (13) and Adult Nursing Care 1 (29), and 97 for the “advanced” students: Maternity Care and Child Health Nursing (18), Mental Health (13), Nursing Care of Older People (12), Community Health Nursing (20) and Adult Nursing Care 2 (34). In addition, 24 interventions were identified as cross-cutting, with training to be provided across all four years of the degree. Conclusion A total of 163 interventions of the NIC list were selected by experts as being both relevant and feasible to nursing undergraduate education. This creates the favourable framework to design high-fidelity scenarios for the training of non-technical skills according to the competences required and in line with the health care reality. Therefore, enabling an optimal combination of theoretical education by academic lecturers with practical training by clinical lecturers and staff nurses. 2020-03-01T00:00:00Z http://hdl.handle.net/20.500.14342/6150 Risk for complicated immigration transition: new diagnosis for NANDA-International Rifà Ros, Rosa; Espinosa Fresnedo, Maria del Carmen; Alcázar París, Mireia; Raigal-Aran, Laia; Ferré-Grau, Carme OBJECTIVEThe objective of this article is to describe the developmental processes for the creation of the new diagnosis risk for complicated immigration transition for the NANDA-I. METHODSThe study followed the recommended steps of developmental processes for NANDA-I. The identification of risk factors,which cause those who have migrated to feel vulnerable, is the result of two different research studies aimed at identifying nursing diagnosis related to the immigration process. RESULTSA proposal of label, definition and risk factors of risk for complicated immigration transition. CONCLUSIONSThis new nursing diagnosis will reinforce the strategies for nursing interventions directed to empower immigrant people to acquire and/or develop the resources needed to cope with the immigration process. 2019-04-01T00:00:00Z http://hdl.handle.net/20.500.14342/6144 Stroke in Latin America: systematic review of incidence, prevalence, and case-fatality in 1997–2021 Delfino, Carlos; Núñez, Marilaura; Asenjo-Lobos, Claudia; Gonzalez McCawley, Francisca; Riviotta, Amy; Urrutia Goldsack, Francisca; Lavados, Pablo; Anderson, Craig; Munoz Venturelli, Paula Background: Stroke is a major global cause of death and disability. Most strokes occur in populations of low-middle-income country (LMIC); therefore, the subsequent disease burden is greater than in populations of high-income countries. Few epidemiological data exist for stroke in Latin America, composed primarily of LMIC. Aims: To determine epidemiological measures of incidence, prevalence, and 1-month case-fatality for stroke in Latin America/Caribbean (LAC) during 1997–2021. Summary of review: A structured search was conducted to identify relevant references from MEDLINE, WOS, and LILACS databases for prospective observational and cross-sectional studies in LAC populations from January 1997 to December 2021. A total of 9242 records were screened and 12 selected for analysis, seven incidence studies and five prevalence studies. Case-fatality was reported in six articles. Sub-group analysis by age, sex, and income countries was performed. A narrative synthesis of the findings was performed. Meta-analysis was performed using random-effect model to obtain pooled estimates with 95% confidence intervals (CIs). Studies quality was assessed according to the risk of bias criteria described in the Joanna Briggs Institute’s guide. The overall crude annual incidence rate of first-ever stroke in LAC was 119.0 (95% CI = 95.9–142.1)/100,000 people (with high heterogeneity between studies (I2 = 98.1%)). The overall crude prevalence was 3060 (95% CI: 95.9–142.1)/100,000 people (with high heterogeneity between studies (I2 = 98.8%)). The overall case-fatality at 1 month after the first stroke was 21.1% (95% CI = 18.6–23.7) (I2 = 49.40%). Conclusion: This review contributes to our understanding regarding the burden caused by stroke in LAC. More studies with comparable designs are needed to generate reliable data and should include both standardized criteria, such as the World Health Organization clinical criteria and updated standard methods of case assurance, data collection, and reporting. 2022-11-01T00:00:00Z http://hdl.handle.net/20.500.14342/6115 Implementing low-intensity thrombolysis monitoring for patients with acute ischemic stroke in Latin America: Insights from the OPTIMISTmain process evaluation Gonzalez McCawley, Francisca; Munoz Venturelli, Paula; Anderson, Craig; Delfino, Carlos; Núñez, Marilaura; Liu, Hueiming; Jakszyn, Paula; Tang, Rachel Zixuan; Río, Alejandra del; Ouyang, Menglu Introduction: The Optimal Post-rtPA-IV Monitoring in Ischemic Stroke Trial (OPTIMISTmain) was an international, pragmatic, stepped-wedge, cluster-randomized, non-inferiority trial designed to compare a low-intensity protocol to standard high-intensity monitoring in patients with mild-to-moderate acute ischemic stroke treated with thrombolysis. The results showed the safety, feasibility, and non-inferiority efficacy of the low-intensity monitoring protocol, supporting hospitals to consider adopting this approach in stroke care depending on local resources and circumstances. An embedded process evaluation was undertaken to explore factors influencing implementation and impact of the intervention in Latin America. Methods: A convergent mixed-methods design was used to combine quantitative data and qualitative interviews with implementers and patients (or family members) at participating hospitals in Chile and Mexico. Purposive sampling ensured that a diverse range of experiences and discourses were captured, and normalization process theory (NPT) guided the identification of factors facilitating or hindering the incorporation of low-intensity monitoring. The analysis focused on key implementation outcomes. Results: Low-intensity monitoring was widely accepted by clinicians who found it efficient, straightforward to implement, and potentially cost saving for hospital services. Patients and families expressed acceptance, emphasizing the protocol’s potential to support continuous improvements in healthcare. Implementation challenges included staff turnover across shifts and hospital units, reliance on external contractors, and resistance to changing established care routines. Factors enabling successful implementation included strong team communication, dedicated stroke units, and ongoing feedback. Overall, the intervention demonstrated high acceptability, adoption and appropriateness, fidelity (median of 17 assessments in both countries), and sustainability. Feasibility outcomes were more variable, reflecting organizational challenges at the healthcare system level, such as initial resistance of nursing teams and high workloads in emergency services. Conclusions: Implementation of a novel low-intensity monitoring protocol was well accepted by healthcare staff and offers potential benefits to patients with mild-to-moderate acute ischemic stroke admitted to hospitals in Latin America. Embedding a process evaluation into the main trial provided valuable insights into the challenges of implementing a complex intervention. A comprehensive understanding of the factors influencing organization change is critical to improving health outcomes. 2025-12-01T00:00:00Z